Prevalence and factors associated with renal insufficiency in patients with lung cancer: A cross-sectional study

The aim of this study was to determine the prevalence of renal insufficiency in patients with lung cancer and factors associated with its development.

All patients at the First Affiliated Hospital of Guangzhou Medical University from January 1 to December 31, 2016 who had lung cancer were included in this study. Baseline characteristics, including age, sex, clinical features, estimated glomerular filtration rate (eGFR), echocardiographic findings, electrocardiogram results, and biochemical indicators were collected retrospectively. eGFR was divided into three categories: ≥ 60, 45 - 59, and < 45 mL/min/1.73m². Renal insufficiency was defined as eGFR < 60 mL/min/1.73m². The prevalence of co-occurring lung cancer and renal insufficiency as well as factors associated with it were also studied.

A total of 140 patients with a lung cancer diagnosis confirmed by pathologic examination were included. The prevalence of eGFR ≥ 60, 45 - 59, and < 45 mL/min/1.73m² categories was 77.14%, 12.14%, and 10.71%, respectively. The lung cancer subtypes were adenocarcinoma (102 cases (72.86%)), squamous cell carcinoma (23 cases (16.43%)), and small cell carcinoma (15 cases (10.71%)). Logistic regression analysis showed that age (odds ratio (OR), 5.522; 95% CI, 2.712 - 11.243; p < 0.001), proteinuria (OR, 4.832; 95% CI, 1.518 - 15.383; p = 0.008), and thyroid-specific transcription factor-1 (TTF-1) positivity (OR, 5.730; 95% CI, 1.509 - 21.754; p = 0.010) were independently associated with eGFR category < 60 mL/min/1.73m². Age (OR, 2.372; 95% CI, 1.331 - 4.228; p = 0.003) and TTF-1 positivity (OR, 12.791; 95% CI, 3.394 - 49.575; p < 0.001) were independently associated with eGFR category 45 - 59 mL/min/1.73m2. Finally, age (OR, 4.083; 95% CI, 1.979 - 8.426; p < 0.001), low albumin (OR, 9.05; 95% CI, 1.335 - 61.349; p = 0.024), and hyperuricemia (OR, 4.974; 95% CI, 1.22 - 20.282; p = 0.025) were independently associated with eGFR category < 45 mL/min/1.73m².

Renal function is an important parameter to monitor in patients undergoing lung cancer treatment. The patient's age and presence of proteinuria, low albumin, hyperuricemia, and TTF-1 positivity in lung cancer are all independently associated with renal insufficiency in these patients. To ensure safe recovery and discharge after lung cancer treatment, factors associated with renal insufficiency should be recognized during treatment. Large-scale multicenter trials are warranted for further validation of these findings.